| Doctor Name: | DR. SHAWN TODD VAN ENOO |
| NPI Number: | 1073540688 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | E4322 |
| Business Practice Address: | 11911 Artesia Blvd 103 Cerritos, CA - 907014070 |
| Business Phone Number: | 5624022489 |
| Business Fax Number: | 5628097219 |
| Mailing Address: | Po Box 111, ARTESIA |
| State: | CA |
| Postal Code: | 907020011 |
| Phone Number: | 5624022489 |
| Fax Number: | 5628097219 |
| NPI Enumeration Date: | 06/27/2006 |
| NPI Last Update Date: | 07/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E4322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |